Summary

The Bruton tyrosine kinase (BTK) inhibitor ibrutinib provides effective treatment for patients with chronic lymphocytic leukemia (CLL), despite extensive heterogeneity in this disease. To define the underlining regulatory dynamics, we analyze high-resolution time courses of ibrutinib treatment in patients with CLL, combining immune-phenotyping, single-cell transcriptome profiling, and chromatin mapping. We identify a consistent regulatory program starting with a sharp decrease of NF-κB binding in CLL cells, which is followed by reduced activity of lineage-defining transcription factors, erosion of CLL cell identity, and acquisition of a quiescence-like gene signature. We observe patient-to-patient variation in the speed of execution of this program, which we exploit to predict patient-specific dynamics in the response to ibrutinib based on the pre-treatment patient samples. In aggregate, our study describes time-dependent cellular, molecular, and regulatory effects for therapeutic inhibition of B cell receptor signaling in CLL, and it establishes a broadly applicable method for epigenome/transcriptome-based treatment monitoring.

Overall design

12 scRNA-seq samples of peripheral blood mononuclear cells from chronic lymphocytic leukemia patients

Contributors

André F Rendeiro # 1, Thomas Krausgruber # 1, Nikolaus Fortelny 1, Fangwen Zhao 1 2, Thomas Penz 1, Matthias Farlik 1, Linda C Schuster 1, Amelie Nemc 1, Szabolcs Tasnády 3, Marienn Réti 3, Zoltán Mátrai 3, Donát Alpár 1 4, Csaba Bödör 4, Christian Schmidl 1 5, Christoph Bock 6 7 8

Contact

cbock@cemm.oeaw.ac.at.(Christoph Bock)